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Officially, the Philippines is a low-HIV-prevalence country, with less than 0.1 percent of the adult population estimated to be HIV-positive. As of September 2008, the Department of Health (DOH) AIDS Registry in the Philippines reported 3,456 people living with HIV/AIDS (PLWHA)- www.plwha.org . UNAIDS estimates that 12,000 Filipinos were HIV-positive by the end of 2005.[1]
Up until 2007, heterosexual intercourse accounted for the majority (61 percent) of the Philippines’ reported HIV/AIDS cases, followed in descending order by homosexual and bisexual relations, mother-to-child transmission, contaminated blood and blood products, and injecting drug use, according to UNAIDS, with men comprising 66 percent of reported cases. However, in 2007 the proportion was reversed, with homosexual and/or bisexual modes of infection surpassing heterosexual transmission — 56% versus 43%, with the figure rising to 67% for the January to September 2008 period, as against 34%.
Overseas workers from the Philippines (e.g., seafarers, domestic helpers, etc.) account for 30-35 percent of all HIV/AIDS cases in the country.
Most-at-risk groups include men who have sex with men (MSM), with 395 new human immunodeficiency virus (HIV) infections among within this group from January to September 2008 alone, 96% up from 2005’s 210 reported infections. A spokesperson of the National Epidemiology Center (NEC) of the Department of Health says that the sudden and steep increase in the number of new cases within the MSM community, particularly in the last three years (309 cases in 2006, and 342 in 2007), is “tremendously in excess of what (is) usually expected,” allowing classification of the situation as an “epidemic". Of the cumulative total of 1,097 infected MSMs from 1984 to 2008, 49% were reported in the last three years (72% asymptomatic); 108 have died when reported, and slightly more MSMs were reportedly already with AIDS (28%).[2]
Among MSM's, ninety percent of the newly infected are single (up to 35% of past cases reported involved overseas Filipino workers or OFWs and/or their spouse), with the most of the affected people now only 20 to 34 years old (from 45 to 49 years old in the past). The highest number of infections among MSMs is from Metro Manila, though increasing infection rates were also noted in the cities of Angeles, Cebu, and Davao.[2] 1 to 3 percent of MSM's were found to be HIV-positive by sentinel surveillance conducted in Cebu and Quezon cities in 2001.
Another at-risk group are injecting drug users (IDUs), 1 percent of whom were found to be HIV-positive in Cebu City in 2005. A high rate of needle sharing among IDUs in some areas (77 percent in Cebu City) is of concern. Sex workers, because of their infrequent condom use, high rates of sexually transmitted infections (STIs), and other factors, are also considered to be at risk. In 2002, just 6 percent of sex workers interviewed said they used condoms in the last week. As of 2005, however, HIV prevalence among sex workers in Cebu City was relatively low, at 0.2 percent.[1]
Several factors put the Philippines in danger of a broader HIV/AIDS epidemic. They include increasing population mobility within and outside of the Philippine islands; a conservative culture, adverse to publicly discussing issues of a sexual nature; rising levels of sex work, casual sex, unsafe sex, and injecting drug use.[1]
There is also high STI prevalence and poor health-seeking behaviors among at-risk groups; gender inequality; weak integration of HIV/AIDS responses in local government activities; shortcomings in prevention campaigns; inadequate social and behavioral research and monitoring; and the persistence of stigma and discrimination, which results in the relative invisibility of PLWHA. Lack of knowledge about HIV among the Filipino population is troubling. Approximately two-thirds of young women lack comprehensive knowledge on HIV transmission, and 90 percent of the population of reproductive age believe you can contract HIV by sharing a meal with someone.[1]
The Philippines has high tuberculosis (TB) incidence, with 131 new cases per 100,000 people in 2005, according to the World Health Organization. HIV infects 0.1 percent of adults with TB. Although HIV-TB co-infection is low, the high incidence of TB indicates that co-infections could complicate treatment and care for both diseases in the future.[1]
Wary of nearby Thailand’s growing epidemic in the late 1980s, the Philippines was quick to recognize its own sociocultural risks and vulnerabilities to HIV/AIDS. Early responses included the 1992 creation of the Philippine National AIDS Council (PNAC), the country’s highest HIV/AIDS policymaking body. Members of the Council represent 17 governmental agencies, including local governments and the two houses of the legislature; seven nongovernmental organizations (NGOs); and an association of PLWHA.[1]
The passing of the Philippine AIDS Prevention and Control Act in 1998 was also a landmark in the country’s fight against HIV/AIDS. However, the Philippines is faced with the challenge of stimulating government leadership action in a low-HIV-prevalence country to advocate for a stronger and sustainable response to AIDS when faced with other competing priorities. One strategy has been to prevent STIs in general, which are highly prevalent in the country.[1]
The PNAC developed the Philippines’ AIDS Medium Term Plan: 2005–2010 (AMTP IV). The AMTP IV serves as a national road map toward universal access to prevention, treatment, care, and support, outlining country-specific targets, opportunities, and obstacles along the way, as well as culturally appropriate strategies to address them. In 2006, the country established a national monitoring and evaluation system, which was tested in nine sites and is being expanded. Antiretroviral treatment is available free of charge, but only 10 percent of HIV-infected women and men were receiving it as of 2006, according to UNAIDS.[1]
The Government of the Philippines participates in international responses to the HIV/AIDS epidemic. Most recently, in January 2007, the Philippines hosted the 12th Association of Southeast Asian Nations Summit, which had a special session on HIV/AIDS.[1]
The Philippines is a recipient of three grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria (2004 third round, 2006 fifth round, and 2007 sixth round) to scale up the national response to HIV/AIDS through the delivery of services and information to at-risk populations and PLWHA.[1]
In 2010, then Philippine Health Secretary Esperanza Cabral said the Philippine government had stopped allocating funds for condoms due to church pressure, a move that Secretary Cabral opposed.[3] Catholic bishops helped build opposition in Congress to block a reproductive health bill that they said promoted sex education and artificial contraceptives.[4]
Dr. Rene Bullecer of AIDS Free Philippines criticized the use of condoms as "not the appropriate solution to the rising HIV cases" He said that "the distribution of condoms is even a form of discrimination against women, particularly those working in bars, because 'it’s as if the government is branding all of them as prostitutes.'"[5] Dr. Bullecer blames Thailand's 100% Condom Use campaign for having brought about its condition as one of the worst hit countries in terms of the epidemic, while the Philippines which has persisted in not doing the same has a low incidence.[6] [7]
Dr. Bernardo Villegas cites the work of Dr. Edward C. Green, Director of Harvard's AIDS Prevention Center to say that more condoms promote the spread of AIDS. Green said that according to the “best studies,” condoms makes people take wilder sexual risks, thus worsening the spread of the disease. Green showed that fidelity and abstinence are the best solutions to the AIDS epidemic.[8]
Although the Philippines is officially a low HIV incidence country, the media often reports that the Philippine government has concealed the extent of the HIV/AIDS problem. Until now it is increasing.[9]
Findings in 2009 showed an increase in the infection rate.[10]
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